RESUMO
Septic peritonitis is a life-threatening disease that can be caused by neoplasia, among other disease processes. There is no veterinary literature directly evaluating the outcome of patients with septic peritonitis caused by neoplasia. The objective of this study was to evaluate for differences in survival to discharge and complication rates between septic peritonitis caused by neoplastic and nonneoplastic disease in canine patients. A single-institution retrospective cross-sectional cohort study was performed, identifying dogs that were treated surgically for septic peritonitis between January 1, 2010, and November 1, 2020. A total of 86 patients were included, 12 with a neoplastic cause for septic peritonitis and 74 with another cause. The most common neoplastic lesions associated with septic peritonitis were gastrointestinal lymphoma and hepatocellular adenoma. Presence of neoplasia was not a significant factor for development of intraoperative or immediate postoperative complications, nor did it decrease chances of survival to discharge (P < .09). The diagnosis of a primary, localized, neoplastic lesion alone should not deter clinicians and owners from pursuing treatment for septic peritonitis.
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Doenças do Cão , Neoplasias , Peritonite , Cães , Animais , Estudos Retrospectivos , Estudos Transversais , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Neoplasias/veterinária , Peritonite/etiologia , Peritonite/cirurgia , Peritonite/veterinária , Resultado do TratamentoRESUMO
The Veterinary Internship and Residency Matching Program (VIRMP) recently revised its electronic standardized letter of reference (SLOR) to improve the quality and usefulness of the data obtained from it and to enhance the relevance of non-cognitive and cognitive candidate attributes assessed. We used a stepwise process including a broad survey of SLOR readers and writers, analysis of past SLORs, and a multi-wave iterative revision that included key stakeholders, such as residency and internship program directors from academia and private practice. Data from the SLOR survey and analysis of past SLOR responses identified opportunities to improve applicant differentiation, mitigate positive bias, and encourage response consistency. The survey and other analytics identified and confirmed performance domains of high relevance. The revised SLOR assesses four performance domains: knowledge base and clinical skills, stress and time management, interpersonal skills, and personal characteristics. Ratings within the revised SLOR are predominantly criterion-referenced to enhance discernment of candidate attributes contained within each domain. Questions assessing areas of strength and targeted mentoring were replaced with free-text boxes, which allow writers to comment on positive and neutral/negative ratings of attributes within domains. Minor revisions were made to certain questions to enhance readability, streamline responses, or address targeted concerns identified in the SLOR survey or stakeholder review. The revised SLOR was deployed in the 2020 VIRMP; data from a survey of writers (n = 647) and readers (n = 378) indicate that the redesign objectives were achieved.
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Educação em Veterinária , Internato e Residência , Animais , Competência Clínica , Seleção de Pessoal , Inquéritos e QuestionáriosRESUMO
Case summary: An 11-year-old male neutered cat was referred to The Ohio State University's Veterinary Teaching Hospital after being diagnosed with pleural effusion by a referral veterinarian. After thoracocentesis, analysis of the effusion was consistent with chyle. Echocardiography, radiographs and bloodwork were used to diagnose hypertrophic cardiomyopathy phenotype and left-sided congestive heart failure, suspected to be secondary to uncontrolled hyperthyroidism. While initiating medical therapy, repeated thoracocenteses were required. A severe pneumothorax developed, necessitating placement of bilateral thoracostomy tubes. A thoracic CT scan did not reveal a cause for the pneumothorax; therefore, it was suspected to have occurred secondarily to an iatrogenic laceration of the parenchyma during thoracocentesis. An autologous blood patch pleurodesis was considered contraindicated so instead the cat was administered a blood patch using blood from a canine blood donor. The cat's respiratory status remained stable without additional intervention. At 30 h after blood patch pleurodesis, the thoracostomy tubes were removed and thoracic radiographs revealed near resolution of the pleural effusion and pneumothorax. The cat remained subclinical and was discharged from the hospital 48 h after the blood patch pleurodesis. Upon follow-up at 4 and 8 weeks after discharge, the cat was alive and had no complications or adverse reactions from the blood patch pleurodesis. Relevance and novel information: This case documents the first report of a xeno-blood patch pleurodesis performed in a cat using blood from a canine donor. The cat had a successful discharge from the hospital with no adverse reactions from the xeno-blood patch pleurodesis.
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OBJECTIVE: Thromboelastography (TEG) is a whole blood assay that yields global assessment of hemostasis, as it evaluates clot time, strength, and kinematics of clot formation and lysis. The main objective was to describe preoperative TEG findings in dogs that had an adrenalectomy performed and, secondarily, to describe TEG findings in the dogs with or without hyperadrenocorticism (HAC). ANIMALS: 30 dogs that had preoperative TEG and adrenalectomy performed. METHODS: Medical records between 2018 and 2022 were reviewed. Signalment, diagnostic data, and perioperative treatment were abstracted. RESULTS: 53% (16/30) of the dogs were hypercoagulable, and none were hypocoagulable. Based on histopathology, 6 of 9 dogs with adenocarcinoma were hypercoagulable, 4 of 8 with pheochromocytoma were hypercoagulable, and 6 of 10 with adenoma were hypercoagulable. None of the 3 dogs with other histopathologic diagnoses or combinations of diagnoses (adrenocortical hyperplasia, poorly differentiated sarcoma, and both adrenocortical adenocarcinoma and pheochromocytoma) were hypercoagulable. Of the 14 dogs tested preoperatively for HAC, 4 of 8 HAC dogs were hypercoagulable and 2 of 6 non-HAC dogs were hypercoagulable. CLINICAL RELEVANCE: The present report describes for the first time TEG findings for dogs undergoing adrenalectomy and suggests that the majority of dogs with adrenal neoplasia are hypercoagulable based on TEG results.
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Adrenalectomia , Hiperfunção Adrenocortical , Doenças do Cão , Tromboelastografia , Trombofilia , Animais , Cães , Tromboelastografia/veterinária , Adrenalectomia/veterinária , Doenças do Cão/cirurgia , Doenças do Cão/diagnóstico , Doenças do Cão/sangue , Masculino , Feminino , Trombofilia/veterinária , Trombofilia/diagnóstico , Hiperfunção Adrenocortical/veterinária , Hiperfunção Adrenocortical/complicações , Estudos Retrospectivos , Neoplasias das Glândulas Suprarrenais/veterinária , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/complicações , Feocromocitoma/veterinária , Feocromocitoma/cirurgiaRESUMO
OBJECTIVE: To evaluate the variability in arterial blood gas (ABG) assessment of pulmonary function with different body positioning in dogs with suspected aspiration pneumonia. KEY FINDINGS: The median differences in alveolar-arterial gradient, Pao2 , and Paco2 values in different recumbencies were not statistically significantly different, both within patients and across the study population. No difference was noted in ABG values in the subgroups with unilateral or bilateral disease or that were more affected on the right side versus the left side. SIGNIFICANCE: This preliminary study provides data that can be used to calculate appropriate sample sizes for subsequent studies investigating the impact of recumbency on pulmonary function in patients with aspiration pneumonia.
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Doenças do Cão , Pneumonia Aspirativa , Cães , Animais , Posicionamento do Paciente/veterinária , Pulmão , Pneumonia Aspirativa/diagnóstico , Pneumonia Aspirativa/veterinária , Gasometria/veterinária , Oxigênio , Doenças do Cão/diagnósticoRESUMO
OBJECTIVE: To evaluate local temperature differences directly over and adjacent to small intestinal foreign body obstruction (FBO) using infrared thermography (IRT) in dogs. ANIMALS: 49 client-owned dogs were initially enrolled. METHODS: In a prospective, clinical observational study, IRT was utilized to compare median small intestinal (SI) surface temperature differences at the site of FBO and segments oral and aboral before and after surgical resolution from April 24, 2019, to July 19, 2020. These differences were evaluated for correlation with canine acute patient physiologic and laboratory evaluation fast (APPLEfast) scoring, lactate, foreign body material (hard vs soft), and blood pressure. RESULTS: There was not a significant surface temperature difference between SI segments at the site of FBO, oral or aboral. After resolution of obstruction, there was a significant decrease in median temperature directly over the FBO (2.4 °C; IQR, -2.55 to 10.6 °C; P = .0043). A decrease in surface temperature of the oral SI segment was appreciated with FBO due to hard material (-1.7 °C; IQR, -5.2 to 3.4 °C), whereas soft material had an increase in SI surface temperature oral to the FBO (+1.1 °C; IQR, 0.3 to 3.2 °C). This difference did not achieve significance (P = .08; Z = 1.75). No correlation was found between APPLEfast, lactate, or blood pressure and SI segment temperatures. CLINICAL RELEVANCE: IRT may be useful diagnostic modality to identify changes in small intestinal surface temperature relating to FBO. Further evaluation is warranted to determine if IRT may be a clinically useful to evaluate intestinal perfusion.
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Doenças do Cão , Corpos Estranhos , Humanos , Animais , Cães , Temperatura , Termografia/veterinária , Laparotomia/veterinária , Estudos Prospectivos , Temperatura Corporal , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Corpos Estranhos/veterinária , Lactatos , Raios Infravermelhos , Doenças do Cão/diagnóstico , Doenças do Cão/cirurgiaRESUMO
OBJECTIVE: To compare the success rates for urethral catheterization in clinical patients using the traditional and 2-catheter techniques when placed by personnel of all experience levels. ANIMALS: 38 female cats and dogs weighing less than 10 kg were prospectively enrolled. METHODS: Enrolled animals were randomized to have a urethral catheter placed by the traditional technique or the 2-catheter method under sedation or general anesthesia. Any qualified hospital personnel of any experience level were allowed to place the catheter. If after 5 minutes the animal was not successfully catheterized, the alternate method was performed. The previous experience of the catheter placer, animal signalment, animal condition that necessitated catheter placement, time to successful placement, and which technique was successful was recorded. RESULTS: The 2-catheter technique was more successful than the traditional method (60.5% and 34.2%, respectively) for urethral catheterization when used by a variety of hospital personnel. The 2-catheter technique was successful in 63.3% of dogs and 66.6% of cats, while the traditional method was successful in 36.6% of dogs and 33.3% of cats. Eight of 9 (88.9%) novice catheter placers that placed their first urinary catheter in this study succeeded with the 2-catheter technique and only 1 was successful with the traditional method. CLINICAL RELEVANCE: The 2-catheter technique has a higher rate of success for placement of female urinary catheters in small patients that are unable to have concurrent digital palpation. This technique may also be helpful in the inexperienced catheter placer population to aid in guidance into the urethral papilla.
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Doenças do Gato , Doenças do Cão , Cateterismo Urinário , Animais , Gatos , Cães , Feminino , Doenças do Gato/terapia , Doenças do Cão/terapia , Uretra , Cateterismo Urinário/veterinária , Cateteres UrináriosRESUMO
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in humans in late 2019 and spread rapidly, becoming a global pandemic. A zoonotic spillover event from animal to human was identified as the presumed origin. Subsequently, reports began emerging regarding spillback events resulting in SARS-CoV-2 infections in multiple animal species. These events highlighted critical links between animal and human health while also raising concerns about the development of new reservoir hosts and potential viral mutations that could alter the virulence and transmission or evade immune responses. Characterizing susceptibility, prevalence, and transmission between animal species became a priority to help protect animal and human health. In this study, we coalesced a large team of investigators and community partners to surveil for SARS-CoV-2 in domestic and free-ranging animals around Ohio between May 2020 and August 2021. We focused on species with known or predicted susceptibility to SARS-CoV-2 infection, highly congregated or medically compromised animals (e.g., shelters, barns, veterinary hospitals), and animals that had frequent contact with humans (e.g., pets, agricultural animals, zoo animals, or animals in wildlife hospitals). This included free-ranging deer (n = 76 individuals), free-ranging mink (n = 57), multiple species of bats (n = 59), and other wildlife in addition to domestic cats (n = 275) and pigs (n = 184). In total, we tested 792 individual animals (34 species) via rRT-PCR for SARS-CoV-2 RNA. SARS-CoV-2 viral RNA was not detected in any of the tested animals despite a major peak in human SARS-CoV-2 cases that occurred in Ohio subsequent to the peak of animal samplings. Importantly, we did not test for SARS-CoV-2 antibodies in this study, which limited our ability to assess exposure. While the results of this study were negative, the surveillance effort was critical and remains key to understanding, predicting, and preventing the re-emergence of SARS-CoV-2 in humans or animals.
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OBJECTIVE: To examine geriatric classification as a predictor of survival in moderate to severely injured dogs denoted by animal trauma triage (ATT) scores ≥3 or modified Glasgow Coma Scale (mGCS) scores ≤14. DESIGN: Retrospective observational cohort study utilizing data collected between September 2013 and May 2019 with follow-up until death or hospital discharge. SETTING: Thirty-one trauma centers including university teaching hospitals and private referral centers. ANIMALS: A total of 6169 dogs entered into the Veterinary Committee on Trauma Registry with complete data entry including age, weight, outcome, mGCS (≤14), and/or ATT (≥3). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The effect of geriatric classification on survival was estimated using shared-frailty cox proportional hazard models. Model 1 dependent variables: death despite intervention or euthanasia due to grave prognosis. Model 2 dependent variables: death by euthanasia due to financial influence or combined influence of finances and grave prognosis. Model 3 evaluated interactions between geriatric classification and moderate versus severe trauma. The shared-frailty models controlled for contributing site as a random effect and other confounding variables, including trauma severity. Model 1: geriatrics had a significantly increased hazard risk (HR) for death (HR = 1.48, P < 0.0001). Model 2: geriatrics had an insignificant increased HR for death (HR = 1.34, P = 0.08). Model 3: geriatrics demonstrated significantly increased mortality risk with moderate level trauma. Additional Model 1 variables independently associated with mortality include ATT perfusion, neurologic, respiratory subscores, mGCS motor subscore, weight, and spinal trauma. Additional Model 2 variables independently associated with mortality include ATT perfusion subscore and neuter status. In general, statistical differences between cohorts were found with regard to lactate, PCV, total protein, and glucose. CONCLUSIONS: Among moderately injured dogs who experienced death despite intervention or euthanasia due to grave prognosis, mortality risk is significantly higher in geriatrics as compared to nongeriatrics.
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Doenças do Cão , Fragilidade , Animais , Cães , Fragilidade/veterinária , Escala de Coma de Glasgow/veterinária , Escala de Gravidade do Ferimento , Sistema de Registros , Estudos Retrospectivos , Centros de TraumatologiaRESUMO
OBJECTIVE: To assess the safety and efficacy of the platelet-like nanoparticle (PLN), and to assess its safety in repeated administration. ANIMALS: 6 purpose-bred dogs. PROCEDURES: The PLN was administered IV at 3 different doses using a randomized crossover design. Each dog received a full dose of 8 X 1010 particles/10 kg, half dose, and 10 times the dose, with a 14-day washout period between doses. Biochemical, prothrombin time, partial thromboplastin time, and fibrinogen analyses were performed at baseline and 96 hours postinfusion. A CBC, kaolin-activated thromboelastography, platelet function assay closure time, and buccal mucosal bleeding time were performed at baseline and 1, 6, 24, 48, 72, and 96 hours postinfusion. RESULTS: No significant changes were observed over time in the thromboelastography parameters, closure time, and buccal mucosal bleeding time. After the administration of the half dose, hematocrit levels decreased significantly at 1, 6, 24, 48, and 96 hours, with all values within the reference range. The platelet count was decreased significantly at hours 1, 6, 24, 48, and 72 after administration of the half dose, with values less than the reference range at all hours but hour 72. No significant changes in serum biochemistry, coagulation panel, and fibrinogen were observed for all doses. No adverse events were noted during the first infusion. Three dogs experienced transient sedation and nausea after repeat infusion. CLINICAL RELEVANCE: The PLN resulted in a dilution of hematocrit and platelets, and did not significantly alter hemostasis negatively. The safety of repeated doses should be investigated further in dogs.
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Hemostasia , Nanopartículas , Animais , Cães , Fibrinogênio , Nanopartículas/efeitos adversos , Tempo de Tromboplastina Parcial/veterinária , Tempo de Protrombina/veterinária , Tromboelastografia/veterináriaRESUMO
BACKGROUND: New drugs for veterinary patients with acute respiratory distress syndrome (ARDS) are urgently needed. Early or late postinfection treatment of influenza-infected mice with the liponucleotide cytidine diphosphocholine (CDP-choline) resulted in decreased hypoxemia, pulmonary edema, lung dysfunction, and inflammation without altering viral replication. These findings suggested CDP-choline could have benefit as adjunctive treatment for ARDS in veterinary patients (VetARDS). OBJECTIVES: Determine if parenterally administered CDP-choline can attenuate mild VetARDS in dogs with aspiration pneumonia. ANIMALS: Dogs admitted to a veterinary intensive care unit (ICU) for aspiration pneumonia. METHODS: Subjects were enrolled in a randomized, double-blinded, placebo-controlled trial of treatment with vehicle (0.1 mL/kg sterile 0.9% saline, IV; n = 8) or CDP-choline (5 mg/kg in 0.1 mL/kg 0.9% saline, IV; n = 9) q12h over the first 48 hours after ICU admission. RESULTS: No significant differences in signalment or clinical findings were found between placebo- and CDP-choline-treated dogs on admission. All dogs exhibited tachycardia, tachypnea, hypertension, hypoxemia, hypocapnia, lymphopenia, and neutrophilia. CDP-choline administration resulted in rapid, progressive, and clinically relevant increases in oxygenation as determined by pulse oximetry and ratios of arterial oxygen partial pressure (Pa O2 mmHg) to fractional inspired oxygen (% Fi O2 ) and decreases in alveolar-arterial (A-a) gradients that did not occur in placebo (saline)-treated animals. Treatment with CDP-choline was also associated with less platelet consumption over the first 48 hours, but had no detectable detrimental effects. CONCLUSIONS AND CLINICAL IMPORTANCE: Ctyidine diphosphcholine acts rapidly to promote gas exchange in dogs with naturally occurring aspiration pneumonia and is a potential adjunctive treatment in VetARDS patients.
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Doenças do Cão , Pneumonia Aspirativa , Síndrome do Desconforto Respiratório , Animais , Cães , Citidina , Citidina Difosfato Colina/uso terapêutico , Doenças do Cão/tratamento farmacológico , Hipóxia/tratamento farmacológico , Hipóxia/veterinária , Pulmão , Oxigênio/uso terapêutico , Pneumonia Aspirativa/veterinária , Síndrome do Desconforto Respiratório/veterinária , Solução SalinaRESUMO
BACKGROUND: Reduced pelvic limb reflexes in dogs with spinal cord injury typically suggests a lesion of the L4-S3 spinal cord segments. However, pelvic limb reflexes might also be reduced in dogs with a T3-L3 myelopathy and concurrent spinal shock. HYPOTHESIS/OBJECTIVES: We hypothesized that statistical models could be used to identify clinical variables associated with spinal shock in dogs with spinal cord injuries. ANIMALS: Cohort of 59 dogs with T3-L3 myelopathies and spinal shock and 13 dogs with L4-S3 myelopathies. METHODS: Data used for this study were prospectively entered by partner institutions into the International Canine Spinal Cord Injury observational registry between October 2016 and July 2019. Univariable logistic regression analyses were performed to assess the association between independent variables and the presence of spinal shock. Independent variables were selected for inclusion in a multivariable logistic regression model if they had a significant effect (P ≤ .1) on the odds of spinal shock in univariable logistic regression. RESULTS: The final multivariable model included the natural log of weight (kg), the natural log of duration of clinical signs (hours), severity (paresis vs paraplegia), and pelvic limb tone (normal vs decreased/absent). The odds of spinal shock decreased with increasing weight (odds ratio [OR] = 0.28, P = .09; confidence interval [CI] 0.07-1.2), increasing duration (OR = 0.44, P = .02; CI 0.21-0.9), decreased pelvic limb tone (OR = 0.04, P = .003; CI 0.01-0.36), and increased in the presence of paraplegia (OR = 7.87, P = .04; CI 1.1-56.62). CONCLUSIONS AND CLINICAL IMPORTANCE: A formula, as developed by the present study and after external validation, could be useful for assisting clinicians in determining the likelihood of spinal shock in various clinical scenarios and aid in diagnostic planning.
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Doenças do Cão , Deslocamento do Disco Intervertebral , Doenças da Medula Espinal , Traumatismos da Medula Espinal , Animais , Doenças do Cão/diagnóstico , Cães , Humanos , Deslocamento do Disco Intervertebral/veterinária , Paraplegia/veterinária , Medula Espinal/patologia , Doenças da Medula Espinal/veterinária , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/veterináriaRESUMO
OBJECTIVE: To describe the outcome of dietary management of canine noninfectious acute colitis with or without concurrent oral administration of metronidazole using a randomized controlled clinical trial. ANIMALS: 59 client-owned dogs with noninfectious acute colitis. PROCEDURES: Dogs with acute noninfectious colitis were enrolled in a 30-day diet trial after exclusion of parasitic infectious etiologies (fecal centrifugation floatation, Giardia/Cryptosporidium antigen testing) and systemic disease (CBC, biochemistry, urinalysis). Dogs were randomized into 3 placebo-controlled groups: group 1, easily digestible diet + placebo tablet; group 2, easily digestible diet + metronidazole tablet; and group 3, psyllium-enhanced easily digestible diet + placebo tablet. Dogs were evaluated serially using fecal scoring for time to remission, average fecal score, relapse after remission, and dysbiosis index. RESULTS: Median remission time was significantly different among the 3 groups (P < .01) with median times of 5 days (range, 4 to 10) for group 1, 8.5 days (range, 7 to 12) for group 2, and 5 days (range, 3 to 6) for group 3. Metronidazole addition affected the fecal dysbiosis index negatively at days 7 to 10. No adverse effects or complications were noted throughout the study. CLINICAL RELEVANCE: For canine noninfectious acute colitis, dietary management with an easily digestible diet with or without psyllium enhancement proved a superior management strategy compared to metronidazole. The omission of metronidazole reduced the adverse impact significantly on intestinal microbiota. Longitudinal clinical trials are necessary to compare the long-term response, stability, and complications associated with dietary management alone versus combined dietary and antimicrobial therapy for canine acute colitis.
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Colite , Criptosporidiose , Cryptosporidium , Doenças do Cão , Psyllium , Cães , Animais , Metronidazol/uso terapêutico , Psyllium/uso terapêutico , Disbiose/tratamento farmacológico , Disbiose/veterinária , Colite/tratamento farmacológico , Colite/veterinária , Doenças do Cão/tratamento farmacológicoRESUMO
OBJECTIVE: To evaluate characteristics of septic shock patients treated with hydrocortisone (HC) due to suspicion of critical illness-related corticosteroid insufficiency (CIRCI) as compared to septic shock patients without suspicion of CIRCI. DESIGN: Retrospective study between February 2010 and October 2017. SETTING: University teaching hospital ICU. ANIMALS: Data were collected for 47 dogs with septic shock. Twenty-one dogs were treated with HC (HC-treated) due to suspicion of CIRCI. Twenty-six dogs did not receive HC (non-HC-treated). INTERVENTIONS: HC was administered either as an intermittent IV bolus or as a constant rate infusion (CRI) to those patients with suspected CIRCI. MEASUREMENTS AND MAIN RESULTS: Significantly higher baseline APPLEfull scores and predicted mortality were detected in the HC-treated patients compared to non-HC-treated patients (0.87 vs 0.44 for predicted mortality, P = 0.039). Patients in the HC-treated group were on more vasopressors and cardiotonics than those in the non-HC-treated group (2.5 vs 1.5, P <0 .001). All patients initially responded to vasopressor administration, with average time to resolution of hypotension being 90 minutes for the HC-treated group compared to 60 minutes for the non-HC-treated group (P = 0.640). However, HC-treated patients took significantly longer to have a sustained resolution (a systolic blood pressure > 90 mm Hg or a mean blood pressure > 65 mm Hg for at least 4 h) of their hypotension after starting vasopressors, as compared to their non-HC-treated counterparts (8.5 vs 4 h, P = 0.001). Three (14.3%) HC-treated patients survived to discharge compared to 9 (34.6%) non-HC-treated patients, but this was not statistically significant. CONCLUSIONS: HC-treated patients had a higher baseline risk of mortality than non-HC-treated patients. There was no significant difference in survival between the HC-treated and non-HC-treated septic shock patients. Further studies are needed to evaluate the use of HC in patients with suspected CIRCI.
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Corticosteroides/deficiência , Doenças do Cão/tratamento farmacológico , Hidrocortisona/uso terapêutico , Choque Séptico/veterinária , Corticosteroides/uso terapêutico , Animais , Estado Terminal , Cães , Feminino , Hidrocortisona/administração & dosagem , Masculino , Estudos Retrospectivos , Choque Séptico/sangueRESUMO
A 3-year-old spayed female Siberian Husky presented for evaluation following ingestion of approximately 429 mg/kg of lamotrigine extended-release. She demonstrated severe neurologic and cardiac signs and was treated with lipid emulsion, anticonvulsants, antiarrhythmics and aggressive decontamination and supportive care. She was successfully discharged from the hospital 5 days later.
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In 2011, Michigan State University College of Veterinary Medicine founded the second veterinary hospice in academic practice. This program was designed to meet the growing demand for veterinary end-of-life care in the community. Veterinary Hospice Care provided patients and their families palliative care services, through utilization of an interdisciplinary team, from the time of terminal diagnosis to the time of death. Families also received dedicated emotional support. As a direct result of the hospice care service, Michigan State University veterinary students as well as in-state technical college students received an increase in end-of-life care in the curriculum.
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Cuidados Paliativos na Terminalidade da Vida , Dor/veterinária , Medicina Veterinária/tendências , Animais , Currículo , Educação em Veterinária , Michigan , Dor/prevenção & controle , UniversidadesRESUMO
OBJECTIVE: To investigate the impact of cryopoor plasma (CPP) continuous rate infusion (CRI) on albumin concentration and colloid osmotic pressure (COP) in critically ill dogs with hypoalbuminemia. DESIGN: Retrospective study between 2013 and 2015 with a 90-day follow-up on survivors. SETTING: University teaching hospital. ANIMALS: Ten hypoalbuminemic dogs receiving a CPP CRI for albumin replacement or oncotic support. All patients with documented hypoalbuminemia or low COP receiving CPP administration for albumin or oncotic support during the study period were included. INTERVENTIONS: CRI of CPP. MEASUREMENTS AND MAIN RESULTS: Mean age was 7.4 ± 4.5 years. Mean survival prediction index score was 0.66 ± 0.13. Seven dogs were septic, with 2 of 7 in septic shock and 5 of 7 having septic peritonitis. The mean pre- and postinfusion albumin was 15 ± 4 g/L and 21 ± 2 g/L, respectively. The median pre- and postinfusion COP was 8.6 mm Hg (4.9-9.7 mm Hg) and 10.2 mm Hg (8.1-13.3 mm Hg), respectively. The median duration of CRI was 16 hours (11-121 h). The mean CPP rate was 1.8 ± 0.6 mL/kg/h, the mean crystalloid rate administered concurrently was 0.8 ± 0.9 mL/kg/h, and the mean hydroxyethyl starch rate administered concurrently was 1.2 ± 0.9 mL/kg/h. The difference in pre- and postinfusion albumin was significantly correlated with CPP rate (P = 0.0004), whereas the difference in pre- and postinfusion COP was correlated with hydroxyethyl starch rate (P = 0.0128). Mean duration of hospitalization was 8.6 ± 3.9 days. Mann-Whitney U and Fisher's exact tests were used to compare survivors and nonsurvivors. Survivors were significantly younger than nonsurvivors (3.5 vs 11.5 y, P = 0.033). No side effects were reported. Survival to discharge was 40% with identical 90-day survival. Of the nonsurvivors, 50% died naturally. CONCLUSIONS: There was an association between the rate of CPP and the change in albumin after CPP CRI in critically ill dogs, suggesting that CPP may be a viable option for treatment of hypoalbuminemia.
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Doenças do Cão/terapia , Fator VIII/uso terapêutico , Fibrinogênio/uso terapêutico , Hipoalbuminemia/veterinária , Animais , Cuidados Críticos , Estado Terminal , Doenças do Cão/sangue , Cães , Fator VIII/administração & dosagem , Feminino , Fibrinogênio/administração & dosagem , Hipoalbuminemia/terapia , Infusões Intravenosas/veterinária , Masculino , Estudos Retrospectivos , Albumina Sérica/metabolismoRESUMO
CASE DESCRIPTION A 2-year-old sexually intact female mixed-breed dog was evaluated at an emergency hospital approximately 5 hours after ingestion of an unknown amount of over-the-counter topical hair growth promoter containing 5% minoxidil foam. Vomiting and signs of lethargy were reported by the owner, and physical examination revealed tachycardia and hypotension. No treatments were performed, and the dog was transferred to a veterinary referral hospital for management of suspected minoxidil toxicosis. CLINICAL FINDINGS On arrival at the referral hospital, the dog was tachycardic (heart rate, 200 to 220 beats/min) and hypotensive (systolic arterial blood pressure, 70 mm Hg). Electrocardiography revealed a regular, narrow-complex tachycardia with no evidence of ventricular ectopy. TREATMENT AND OUTCOME Hypotension was effectively managed with a constant rate infusion of dopamine hydrochloride (12.5 µg/kg/min [5.7 µg/lb/min], IV). Once normotensive, the dog remained tachycardic and a constant rate infusion of esmolol hydrochloride (40 µg/kg/min [18.2 µg/lb/min], IV) was initiated for heart rate control. A lipid emulsion was administered IV as a potential antidote for the toxic effects of the lipophilic minoxidil, with an initial bolus of 1.5 mL/kg (0.7 mL/lb) given over 15 minutes followed by a continuous rate infusion at 0.25 mL/kg/min (0.11 mL/lb/min) for 60 minutes. While hospitalized, the dog also received maropitant citrate and ondansetron. Resolution of clinical signs was achieved with treatment, and the dog was discharged from the hospital 36 hours after admission. Four days later, the owner reported that the dog had made a full recovery and had returned to its typical behavior and activity level at home. CLINICAL RELEVANCE To the authors' knowledge, this is the first report of successful clinical management of accidental minoxidil toxicosis in a dog.